Sleep disturbances in posttraumatic stress disorder: Updated review and implications for treatment

Sleep disturbances are common in adults with posttraumatic stress disorder (PTSD) and range from insomnia and nightmares to periodic leg movements and disruptive nocturnal behaviors. Together, these findings suggest profound disturbances in rapid eye movement (REM) and non-REM sleep, although there is a lack of consensus regarding a distinct profile of objective sleep disturbances associated with PTSD. Prospective longitudinal studies have established that sleep disturbances represent a risk factor for the development and course of PTSD, suggesting that sleep is an important neurobiologic mechanism in the etiology and maintenance of this disorder. This research highlights the importance of early identification and treatment of sleep disturbances in at-risk and trauma-exposed populations. A number of psychologic and pharmacologic treatments are effective at treating sleep disturbances in PTSD. Additional research is needed to further develop clinical guidelines informing when and how to integrate sleep-specific treatment with PTSD-focused clinical care.